Post-Spinal a Rare Complication and Treatment: Tinnitus and Epidural Blood Patch.

Rare auditory symptoms such as tinnitus after spinal anaesthesia have been observed (1-4). It can be accompanied by headache (1, 4) and can become chronic and affect a patient’s quality of life. In this case, we aimed to present our clinical experience regarding the relief of symptoms by an epidural blood patch in a patient who developed headache and bilateral tinnitus following spinal anaesthesia. A 31-year-old female patient, who was 58 kg in weight and 169 cm in height, was scheduled for operation under spinal anaesthesia due to venous stasis. Informed written consent was obtained. The spinal space was accessed with a 25-G Quincke needle on the first try through the L4–5 interspinous space. On observing a clear cerebrospinal fluid leak, 12.5 mg of hyperbaric bupivacaine and 15 μg of fentanyl were intrathecally administered in a volume of approximately 3 mL. The patient was admitted to the hospital on the first postoperative day due to severe headache that started from the nape of the neck and that involved the entire head. The headache was accompanied by tinnitus (ringing in both ears and motor noise) and nausea–vomiting and was more prominent in the standing and sitting positions. The patient was chiefly discomforted by the tinnitus. The headache diminished while in the lying position, but the tinnitus did not subside. An intravenous access was established in the patient, and she was hydrated. An oral caffeinated analgesic and antiemetic were started. The headache alleviated on the second day of admission, but the tinnitus remained. The patient was unable to sleep and expressed that she was extremely discomforted by this. Given that it was accompanied by headache, we thought that the patient could benefit from an epidural blood patch. Following appropriate site cleaning, approximately 12 mL of the blood patch was epidurally administered by accessing the same space. The tinnitus in the left ear immediately improved following the injection, while it disappeared within approximately 12 h in the right ear. Additionally, the complaint of pain, which lost its severity with the medical treatment, completely disappeared.